Council archive · source document
20170526 - DA Form 2 · 51901.3589.03
Attached to the e-mail Changes Application - 51901.3589.03.
DA Form 2 – Building work details
Approved form (version 1.0 effective 3 July 2017) made under Section 282 of the Planning Act 2016.
This form must be used to make a development application involving building work.
For a development application involving building work only, use this form (DA Form 2) only. The DA Forms Guide
provides advice about how to complete this form.
For a development application involving building work associated with any other type of assessable development,
use DA Form 1 – Development application details and parts 4 to 6 of this form (DA Form 2).
Unless stated otherwise, all parts of this form must be completed in full and all required supporting information must
accompany the development application.
One or more additional pages may be attached as a schedule to this development application if there is insufficient space
on the form to include all the necessary information.
This form and any other form relevant to the development application must be used to make a development application
relating to strategic port land and Brisbane core port land under the Transport Infrastructure Act 1994, and airport land
under the Airport Assets (Restructuring and Disposal) Act 2008. For the purpose of assessing a development
application relating to strategic port land and Brisbane core port land, any reference to a planning scheme is taken to
mean a land use plan for the strategic port land, Brisbane port land use plan for Brisbane core port land, or a land use
plan for airport land.
Note: All terms used in this form have the meaning given under the Planning Act 2016, the Planning Regulation 2017, or the Development
Assessment Rules (DA Rules).
PART 1 – APPLICANT DETAILS
1) Applicant details
Applicant name(s) (individual or company full name) JANE CLARE DUNLOP C/- LISANG DESIGN
Contact name (only applicable for companies) LISA SMITH
Postal address (PO Box or street address) 64 ALLAMBI TCE
Suburb NOOSA HEADS QLD
State QLD
Postcode 4567
Country
Contact number
Email address (non-mandatory) [email protected]
Mobile number (non-mandatory) 0438 874 555
Fax number (non-mandatory)
Applicant’s reference number(s) (if applicable)
PART 2 – LOCATION DETAILS
2) Location of the premises (complete 2.1 and/or 2.2 if applicable)
Note: Provide details below and attach a site plan for any or all premises part of the development application. For further information, see DA Forms
Guide: Relevant plans.
2.1) Street address and lot on plan
Street address AND lot on plan (all lots must be listed), or
Street address AND lot on plan for an adjoining or adjacent property of the premises (appropriate for development in water
but adjoining or adjacent to land e.g. jetty, pontoon. All lots must be listed).
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Unit No. Street No. Street Name and Type Suburb
4 1-3 RUSSELL STREET NOOSAVILLE QLD
Postcode Lot No. Plan Type and Number (e.g. RP, SP) Local Government Area(s)
4566 LOT 4 BUP 4699 NOOSA COUNCIL
2.2) Additional premises
Additional premises are relevant to this development application and the details of these premises have been
attached in a schedule to this development application
3) Are there any existing easements over the premises?
Note: Easement uses vary throughout Queensland and are to be identified correctly and accurately. For further information on easements and how
they may affect the proposed development, see the DA Forms Guide
Yes – All easement locations, types and dimensions are included in plans submitted with this development
application
No
PART 3 – FURTHER DETAILS
4) Is the application only for building work assessable against the building assessment provisions?
Yes – proceed to 8)
No
5) Identify the assessment manager(s) who will be assessing this development application
Pacific BCQ
6) Has the local government agreed to apply a superseded planning scheme for this development application?
Yes – a copy of the decision notice is attached to this development application
The local government is taken to have agreed to the superseded planning scheme request – relevant documents
attached
No
7) Information request under Part 3 of the DA Rules
I agree to receive an information request if determined necessary for this development application
I do not agree to accept an information request for this development application
Note: By not agreeing to accept an information request I, the applicant, acknowledge:
• that this development application will be assessed and decided based on the information provided when making this development application
and the assessment manager and any referral agencies relevant to the development application are not obligated under the DA Rules to accept
any additional information provided by the applicant for the development application unless agreed to by the relevant parties.
• Part 3 of the DA Rules will still apply if the application is an application listed under section 11.3 of the DA Rules.
Further advice about information requests is contained in the DA Forms Guide.
8) Are there any associated development applications or current approvals?
Yes – provide details below or include details in a schedule to this development application
No
List of approval/development Reference Date Assessment manager
application
Approval
TPC1114 Unknown Noosa Council
Development application
Approval
Development application
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DA Form 2 – Development Application details
Version 1.0—3 July 2017
Page 3
9) Has the portable long service leave levy been paid?
Yes – the yellow local government/private certifier’s copy of the receipted QLeave form is attached to this
development application
No – I, the applicant will provide evidence that the portable long service leave levy has been paid before the
assessment manager decides the development application. I acknowledge that the assessment manager may give a
development approval only if I provide evidence that the portable long service leave levy has been paid
Not applicable
Amount paid Date paid (dd/mm/yy) QLeave levy number (A, B or E)
$
10) Is this development application in response to a show cause notice or required as a result of an enforcement notice?
Yes – show cause or enforcement notice is attached
No
11) Identify any of the following further legislative requirements that apply to any aspect of this development application
The proposed development is on a place entered in the Queensland heritage register or in a local
government’s Local Heritage Register. See the guidance provided at www.ehp.qld.gov.au about the
requirements in relation to the development of a Queensland heritage place
Name of the heritage place: Place ID:
PART 4 – REFERRAL DETAILS
12) Does this development application include any building work aspects that have any referral requirements?
Yes – the Referral checklist for building work is attached to this development application
No – proceed to Part 5
13) Has any referral agency provided a referral response for this development application?
Yes – referral response(s) received and listed below are attached to this development application
No
Referral requirement Referral agency Date referral response
Identify and describe any changes made to the proposed development application that was the subject of the referral
response and the development application the subject of this form, or include details in a schedule to this development
application (if applicable)
PART 5 – BUILDING WORK DETAILS
14) Owner’s details
Tick if the applicant is also the owner and proceed to 15). Otherwise, provide the following information.
Contact name (applicable for companies)
Postal address (P.O. Box or street address)
Suburb
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DA Form 2 – Development Application details
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State
Postcode
Contact number
Email address (non-mandatory)
Mobile number (non-mandatory)
Fax number (non-mandatory)
15) Builder’s details
Tick if a builder has not yet been engaged to undertake the work and proceed to 16). Otherwise provide the following
information.
Name(s) (individual or company full name)
Contact name (applicable for companies)
QBCC licence or owner – builder number
Postal address (P.O. Box or street address)
Suburb
State
Postcode
Contact number
Email address (non-mandatory)
Mobile number (non-mandatory)
Fax number (non-mandatory)
16) Provide details about the proposed building work
a) What type of approval is being sought?
Development permit
Preliminary approval
b) What is the level of assessment?
Code assessment
Impact assessment (requires public notification)
c) Nature of the proposed building work (tick all applicable boxes)
New building or structure Repairs, alterations or additions
Change of building classification (involving building work) Swimming pool and/or pool fence
Demolition Relocation or removal
d) Provide a description of the work below or in an attached schedule.
ALTERATIONS & ADDITIONS TO EXISTING UNIT INC INSTALLATION OF LIFT
e) Proposed construction materials
Double brick Steel Curtain glass
External walls Brick veneer Timber Aluminium
Stone/concrete Fibre cement Other
Timber Steel Aluminium
Frame
Other
Floor Concrete Timber Other
Slate/concrete Tiles Fibre cement
Roof covering
Aluminium Steel Other
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DA Form 2 – Development Application details
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f) Existing building use/classification? (if applicable)
Class 2
g) New building use/classification? (if applicable)
h) Relevant plans
Note: Relevant plans are required to be submitted for all aspects of this development application. For further information, see DA Forms Guide:
Relevant plans.
Relevant plans of the proposed works are attached to the development application
17) What is the monetary value of the proposed building work? $ TBA
18) Has Queensland Home Warranty Scheme Insurance been paid?
Yes – provide details below
No
Amount paid Date paid (dd/mm/yy) Reference number
$
PART 6 – CHECKLIST AND APPLICANT DECLARATION
19) Development application checklist
The relevant parts of Form 2 – Building work details have been completed Yes
This development application includes a material change of use, reconfiguring a lot or Yes
operational work and is accompanied by a completed Form 1 – Development
application details Not applicable
Relevant plans of the development are attached to this development application
Note: Relevant plans are required to be submitted for all aspects of this development application. For further Yes
information, see DA Forms Guide: Relevant plans.
The portable long service leave levy for QLeave has been paid, or will be paid before a Yes
development permit is issued Not applicable
20) Applicant declaration
By making this development application, I declare that all information in this development application is true and
correct
Where an email address is provided in Part 1 of this form, I consent to receive future electronic communications
from the assessment manager and any referral agency for the development application where written information is
required or permitted pursuant to sections 11 and 12 of the Electronic Transactions Act 2001
Note: It is unlawful to intentionally provide false or misleading information.
Privacy – Personal information collected in this form will be used by the assessment manager and/or chosen assessment
manager, any referral agency and/or building certifier (including any professional advisers which may be engaged by
those entities) while processing, assessing and deciding the development application.
All information relating to this development application may be available for inspection and purchase, and/or published
on the assessment manager’s and/or referral agency’s website.
Personal information will not be disclosed for a purpose unrelated to the Planning Act 2016, Planning Regulation 2017
and the DA Rules except where:
• such disclosure is in accordance with the provisions about public access to documents contained in the Planning Act
2016 and the Planning Regulation 2017, and the access rules made under the Planning Act 2016 and Planning
Regulation 2017; or
• required by other legislation (including the Right to Information Act 2009); or
• otherwise required by law.
This information may be stored in relevant databases. The information collected will be retained as required by the Public
Records Act 2002.
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DA Form 2 – Development Application details
Version 1.0—3 July 2017
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PART 7 – FOR OFFICE USE ONLY - FOR COMPLETION BY THE ASSESSMENT
MANAGER
Additional building details required for the Australian Bureau of Statistics
Existing building use/classification? (if applicable)
New building use/classification?
Site area (m2) Floor area (m2)
Additional information required by the local government
Confirm proposed construction materials:
Double brick Steel Curtain glass
External walls Brick veneer Timber Aluminium
Stone/concrete Fibre cement Other
Timber Steel Aluminium
Frame
Other
Floor Concrete Timber Other
Slate/concrete Tiles Fibre cement
Roof covering
Aluminium Steel Other
Date received: Reference numbers: 20170526
For completion by the building certifier
Classification(s) of approved building work QBCC Insurance receipt QBCC Certification Licence
number number
Notification of engagement of alternate chosen assessment manager
Prescribed assessment manager N/A
Name of chosen assessment manager N/A
Date chosen assessment manager engaged N/A
Contact number of chosen assessment manager N/A
Relevant licence number(s) of chosen assessment N/A
manager
The Planning Act 2016, the Planning Regulation 2017 and the DA Rules are administered by the Department of
Infrastructure, Local Government and Planning. This form and all other required development application materials should
be sent to the assessment manager.
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DA Form 2 – Development Application details
Version 1.0—3 July 2017
Used in these records
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